Individual provider Active NPI

Jacqueline Luu, PHARMD

  • Pharmacist
  • Menifee, CA
National Provider Identifier
1962064774
Registry record updated Jul 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
77071 Issued in CA
Practice address
26973 Newport Rd
Menifee, CA 92584-9221
Phone
(951) 301-6356
NPI assigned
Jul 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 77071 CA Primary

Addresses

Primary practice location

26973 Newport Rd
Menifee, CA 92584-9221

Mailing address

2091 Goldenbush Dr
Corona, CA 92882-7998
Phone (909) 993-7613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

Practice roles

OrganizationSpecialtyStatusNew patients
Garfield Beach CVS LLC Past Accepting new patients
Garfield Beach CVS, L.L.C. Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561939200000",
    "number": "1962064774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2091 GOLDENBUSH DR",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928827998",
            "telephone_number": "909-993-7613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26973 NEWPORT RD",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925849221",
            "telephone_number": "951-301-6356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUU",
        "first_name": "JACQUELINE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-01",
        "last_updated": "2019-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "77071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Menifee, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.